Soft tissue sarcoma (STS) treatment-related morbidity can be quite challenging. Major wound complications remain the most important cause of morbidity following STS resection. Multiple independent risk factors have been identified including the utilization of radiation therapy, tumour location and size, surgical factors, and host factors. While most wound complications are successfully treated, they can be very time-consuming and costly. Flap reconstruction and vacuum-assisted wound therapy may be beneficial in both the prevention and treatment of major wound complications. Neoadjuvant radiation has a higher propensity for acute wound healing complications following STS resection while adjuvant radiation is associated with late complications including fibrosis, joint stiffness, pain, and lymphedema, which contribute to worse functional outcomes. Radiation-induced pathologic fractures are uncommon but challenging and very problematic to treat. The efficacy of chemotherapy in the management of localized STS remains debatable, but the toxicity profile often remains unacceptable, particularly in older patients with STS. Bone, major nerve, and blood vessel preservation are favoured when the STS abuts but does not invade or encase these structures. Over 90% of patients with STS can be treated with limb-salvage surgery with only a small subset requiring primary amputations. Major vessel, nerve, and bone resections alone are not contraindications to limb-salvage surgery.